Last Updated on by Dr. Ronaye Calvert-Conley
Alcoholism is a severe and devastating chronic illness.
Without proper treatment, alcohol abuse can lead to permanent physical and mental problems or even death.
Many people aren’t aware that long-term alcohol and/or drug abuse can interfere with the human body’s ability to absorb nutrients from food and use the enzymes to perform vital tasks.
In essence, that’s the story behind a condition commonly known as “wet brain” or formally, Wernicke-Korsakoff syndrome.
Here’s how this condition works, what treatment looks like, and why people with alcohol abuse syndrome have a particularly high risk of developing it.
What is Wet Brain?
Wet brain syndrome refers to brain damage caused by chronic alcoholism. Interestingly, it actually takes place in two phases: (acute) Wernicke encephalopathy and (chronic) Korsakoff psychosis.
Together, the condition is called Wernicke-Korsakoff syndrome, referring to both the acute and chronic forms of the illness, and stems from a thiamine or vitamin B1 deficiency.
After the brain’s supply of B1 run dry, lesions begin forming, and symptoms may start to appear. Only about 10% of people with Wernicke encephalopathy will experience all of the symptoms below so it can present a challenge to identify in loved ones.
- Muscle weakness, poor coordination, or trouble walking
- Rapid eye movements or drooping eyes
- Memory loss
- Double vision
In many cases, prompt medical treatment can address the cause of Wernicke encephalopathy and reverse a patient’s syndromes.
If left untreated, Wernicke encephalopathy progresses into a condition called Korsakoff psychosis – this progression happens in 80 to 90 percent of Wernicke cases.
Unlike Wernicke, however, the brain damage from Korsakoff psychosis is often permanent. Unfortunately, family members and friends may not notice Wernicke symptoms until the condition has progressed into Korsakoff, so it’s important to be alert.
Once it reaches the Korsakoff phase, symptoms will get worse and may include
- Amnesia – especially for recent events
- Cognitive problems
- Trouble understanding conversations or information
- Problems understanding the context of words or putting thoughts into words
- Making up exaggerated stories – often to fill in memory loss gaps
Without immediate and intense treatment from a qualified doctor, a vitamin B1 deficiency that has progressed into Korsakoff syndrome can lead to coma and sudden death.
What Causes Wet Brain Syndrome?
A vitamin B1 or thiamine deficiency causes wet brain syndrome.
Usually, a person with Korsakoff syndrome is either malnourished or suffering from an underlying condition that interferes with their body’s ability to absorb thiamine from food and process it to use in the brain.
Like many other B vitamins, thiamine plays a vital role in brain and general central nervous system health. Low – or nonexistent – levels of thiamine can lead to severe brain cell damage in parts of the brain responsible for memory and muscle movement.
Who is Most At-risk for Developing Wet Brain Syndrome?
People suffering from chronic alcoholism are most likely to develop wet brain syndrome. That’s why it’s so important for friends and family members to monitor their loved ones with alcohol abuse problems.
However, Wernicke-Korsakoff can also develop in many people who don’t drink. Other factors that can contribute to a vitamin B1 deficiency include
- Eating disorders like anorexia or bulimia
- Morning sickness during pregnancy
- Kidney dialysis
- Gastric bypass or other weight-loss surgeries
- Extended diarrhea or water loss which can flush vitamin B1 from the body
Why Does Wernicke-Korsakoff Syndrome Develop So Frequently in Alcoholics?
The National Organization for Rare Diseases says that up to 2 percent of the general population suffer from wet brain syndrome. Studies suggest that a large majority – about 80 percent – of people with alcohol use disorders suffer from a vitamin B1 deficiency, which leads to wet brain.
Chronic alcohol use makes it difficult for the intestines to absorb thiamine from food. Since alcohol is processed as glucose, this may also interfere with the way the brain uses thiamine and glucose.
People with alcohol use disorders may also lack the energy or motivation to prepare healthy meals filled with nutrient-rich foods that contain vitamin B1 like whole grains, kale, asparagus, cauliflower, nuts, beef, eggs, and pork.
Since the heat from cooking destroys much of a food’s thiamine content, it’s essential to take a multivitamin to avoid any potential deficiency – even in people who don’t drink regularly.
How Common is Alcoholism?
Over 33 percent of adults in the United States admit to being “heavy drinkers” with 26.9 percent binge drinking and another 7 percent using alcohol “heavily” in the past month.
The National Institute on Alcohol Abuse and Alcoholism estimates that over 6 percent of the American population suffers from an alcohol use disorder. However, many people suffering from chronic alcohol use problems may be reluctant to admit the extent of their drinking, which can skew studies.
In other words, alcoholism is likely much more prevalent than people realize.
Although more men have alcoholism than women on paper, trends like “wine culture” or “mommy juice” have started to shine a light on the rampant issue of casual alcoholism in women.
Considering that over half of adults (and plenty of teens) admit to drinking at some point each month, everyone should do their due diligence learning how to spot the symptoms of low vitamin B1 levels and the progression of wet brain syndrome.
Which Other Vitamin Deficiencies are Common with Chronic Alcoholism?
People with chronic alcohol abuse syndrome are usually deficient in many common vitamins and minerals – not just B1. These nutrients play important roles in vital processes throughout the body: some mental, others physical.
In general, most people who drink regularly or abuse alcohol tend to lack many B vitamins:
- B1: thiamine
- B2: riboflavin
- B3: niacin
- Folic acid
- Pantothenic acid
Other common nutrient deficiencies may include
- Vitamin C
- Omega-3 fatty acids
Low levels of these vitamins are commonly linked with depression, chronic fatigue, chronic stress, muscle spasms, weakness, and sleep disturbances.
Meanwhile, low levels of manganese can also lead to B vitamin deficiencies like thiamine because manganese is an essential mineral for assisting the body with B vitamin absorption.
What is the Treatment for Wernicke-Korsakoff Syndrome?
A vitamin B1 deficiency is serious business – even before it progresses into chronic Korsakoff syndrome.
That’s why it’s so important to consume enough thiamine through foods like whole-grain cereals, take a multivitamin to fill nutritional gaps, and get blood tests done to rule out a deficiency in anyone at-risk for wet brain syndrome.
If a person is thought to have Wernicke-Korsakoff, their doctor will conduct bloodwork to test vitamin B1 levels.
Unfortunately, many physicians may initially attribute the symptoms of wet brain to physical conditions or other problems so it can often take some time to receive an official diagnosis and begin appropriate treatment.
Voicing a loved one’s alcohol abuse risk factor for Wernicke-Korsakoff to the doctor can help speed along tests and diagnosis. Speedy treatment is crucial for slowing brain damage and avoiding potential death from lack of vitamin B1 in the central nervous system.
If a doctor determines a patient is suffering from a thiamine deficiency, treatment will depend on the severity of brain damage and other factors.
In most cases, patients with Korsakoff syndrome will receive thiamine hydrochloride through an IV drop at the hospital as soon as possible.
An IV will administer thiamine directly into the bloodstream and bypass any absorption problems relating to the stomach or intestines. Plus, the body can only absorb a minimal amount of food or supplement-based vitamin B1, so an IV provides a much better option.
Most patients require IV thiamine for at least three days. Medical staff will monitor bloodwork and vitamin levels to determine the necessary length of treatment.
If a patient also has low blood sugar levels, giving them sugar or carbohydrates without thiamine can actually increase their risk of developing Wernicke encephalopathy. Doctors will carefully administer thiamine as soon as blood sugar stabilizes.
Usually, a person suffering from wet brain syndrome will also require treatment for underlying causes. Alcoholism, for example, requires a multifaceted physical and mental health program.
Patients with alcohol use disorders will also need bloodwork to test liver enzyme levels and check for liver damage.
After someone with an alcohol issue gets their physical health in order at the hospital, they’ll need to begin addiction recovery treatment to avoid relapsing. Continuing to drink after developing Korsakoff will lead to another vitamin B deficiency and cause symptoms to return – often much worse than before.
Is Wet Brain Syndrome Reversible?
Wernicke encephalopathy is reversible because it’s the acute phase of the condition.
With prompt IV thiamine treatment, home supplementation, treating underlying conditions, and a healthy diet, it’s entirely possible to reverse and fully recover from Wernicke encephalopathy.
Once Wernicke progresses into the chronic phase (Korsakoff syndrome); however, most of the serious symptoms are not curable or reversible.
With speedy thiamine treatment, someone with Korsakoff may be able to reduce or even eliminate physical symptoms:
- Droopy eyes
- Rapid eye movement
- Vision problems
- Balance and walking issues
- Slurred speech
Unfortunately, much of the brain damage and subsequent mental health symptoms are permanent:
- Memory loss
- Cognitive problems
- Trouble processing or interpreting conversations or information
If alcohol abuse has caused significant nerve damage, these symptoms may also be permanent:
- Numbness and tingling in hands and feet
- Muscle spasms or cramps
- Digestive problems
- Difficulty swallowing
- Speech problems
People with irreversible wet brain symptoms can benefit from seeking professional treatment for individual conditions through medications, therapy, and plenty of support from loved ones.
At the end of the day, maintaining sobriety and a comprehensive recovery program are essential for avoiding alcohol or drug relapse.
What Should Someone Do for a Loved One with Korsakoff Syndrome?
Living or working with someone who’s suffering from Korsakoff syndrome can feel extremely frustrating. Loved ones may attribute a person’s confusion, aggressiveness, or irritability to maliciousness or a character flaw.
However, it’s important to let loved ones with this syndrome know that they have support and that treatment is available. If left untreated, wet brain syndrome can lead to coma and death, so a fast diagnosis and treatment are crucial for stabilizing a patient and improving health.
Dr. Ronaye Calvert-Conley is the CEO and Founder of Revive Detox, a Joint Commission Accredited and Legit Script Certified Addiction Treatment Center in Los Angeles, CA. She earned her Doctorate in Clinical Psychology from Alliant International University in Los Angeles in 2007 and has extensive experience working in the addiction and recovery field and the LGBT community. To learn more about Dr. Calvert-Conley click here.
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